An Athletic 59-YO Male with a DVT

Here is one of our April 22, 2018 Medical Laboratory Professionals Week case studies for your response. Watch for more “Lab Week” case studies in the weeks ahead! I (George) have corresponded with a gentleman since 2009; we’ve developed an electronic friendship, though we’ve never met F2F. “John” first contacted me in 2009, a year […]

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Thrombophilia

Mar 28 2018

george

Protein S Activity < 1%

George had a phone conversation with a reference lab colleague who generated protein S levels on a patient specimen: free and total protein S concentrations over 70%, clot-based protein S activity less than 1%. PT normal, PTT prolonged by about 15 seconds. DRVVT prolonged, not shortened by platelet phospholipid-rich reagent. What could account for these […]

Thrombophilia

D-dimer Controls

In 2008, John Olson, MD provided a lengthy comment on the variabilities of D-dimer assay results, and since then a look-back reveals the number of discussions we’ve held about the variability in D-dimer reporting and how this affects clinical decision making. In the years since Dr. Olson’s post little has been accomplished to harmonize D-dimer […]

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Quick Question Archive

Jan 11 2018

george

Age-adjusted D-dimer, 12/2017 CAP Today

The December CAP Today featured an article about age-adjusted D-dimer assay reference intervals.The article features interviews with Drs. Russell Higgins, Dorothy Adcock, Karen Moser, Oksana Volod, and Chris Lehman. See also our in-depth on this topic in response to a November 8, 2014 entry from Sylvia Stacy, Concord Hospital, NH. It appears from the CAP […]

Thrombophilia

November Quick Question: Thrombophilia

Here are the results of our November, 2017 Quick Question, answered by 60 respondents: Question: When should you perform an antithrombin, protein C, and protein S profile? a. Soon after starting anticoagulant therapy: chosen by 0 respondents, 0% b. Just after a thrombotic event but before starting anticoagulant: chosen by 10 respondents, 17% c. Seven […]

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Quick Question Archive

Nov 2 2017

george

When to Collect Thrombophilia Specimens

George has been communicating with Drs. Elaine Keohane (Rutgers) and Larry Smith (Abbott) about how long to wait after a thrombotic event to collect a specimen for a thrombosis risk profile. Thrombosis risk profiles include assays for antithrombin, protein C, and protein S deficiencies, which can’t be accurately measured during periods of acute inflammation (such […]

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Anticoagulant Therapy

Oct 14 2017

george

Factor V Leiden Blog

My name is Bob Grant and I have Factor V Leiden (factor V Leiden mutation, FVL). I have just launched the Factor V Leiden Blog™. I am looking for contributors and/or participants for this site. I am also hoping for ideas on what I might add to the site and/or how to improve it. I […]

Thrombophilia

Antithrombin Deficiency Affects Heparin Assays

Another important issue addressed by Dr. James Quesenberry, St. Luke’s Laboratory, Sioux City, Iowa. His message: I understood from early on that antithrombin (AT, antithrombin III, ATIII) deficient patients can’t be assayed for unfractionated heparin using the Stago chromogenic anti-Xa heparin assay. I thought this was an all-or-none issue, only a big deal in congenital […]

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Anticoagulant Therapy

Oct 13 2017

george

World Thrombosis Day Today

World Thrombosis Day Today, Friday, October 13: Engage Your Patients, Colleagues or Students WTD 2017 is focused on venous thromboembolism (VTE) and hospitalization as a leading risk factor for VTE. VTE can be prevented, yet patients at high risk for developing the condition often don’t receive life-saving prevention. Engage with your patients, colleagues and/or students […]

Thrombophilia

C-reactive Protein

From Ali Sadeghi-Khomami, Precision BioLogic: Hi George, First of all congratulations for a decade of your valuable blog. It came certainly a long way and proudly as well. Your blog nowadays is the first site visited by many researchers who are seeking to find a solution for their coag problem. I hope to see its […]

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Arterial Thrombosis

Thrombophilia

An Athletic 59-YO Male with a DVT

Protein S Activity < 1%

D-dimer Controls

Age-adjusted D-dimer, 12/2017 CAP Today

November Quick Question: Thrombophilia

When to Collect Thrombophilia Specimens

Factor V Leiden Blog

Antithrombin Deficiency Affects Heparin Assays

World Thrombosis Day Today

C-reactive Protein

George Fritsma MS MLS

Cheat Sheets from George

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Quick Question